Children with chronic illnesses have a doubled risk of developing psychosocial maladjustment--emotional problems, behavior disorder or difficulties in social relationships. Social work support and counselling aims to reduce this secondary morbidity, and is a common form of hospital-based psychosocial service. The first randomized controlled trial of this type of intervention was carried out to evaluate its effectiveness in treating and preventing maladjustment. This thesis describes how child behavior outcomes were assessed before and 4 months after a 6 month period of social worker assistance in 173 children randomized to intervention, and in 169 controls, all with chronic illnesses. / No significant difference between intervention and control groups in the overall prevalence of maladjustment was found. There was no evidence to support a therapeutic or preventive effect of social work counselling on child behavior outcomes, nor was there improvement in child perceived competence. A search for treatment interactions failed to reveal any sub-group that benefitted from the intervention, and restriction of the analysis to individuals who actually received the intervention does not alter any of these conclusions. / Measurement problems, co-intervention, or other forms of bias cannot account for the negative results. It is speculated that if social work support is to be effective, it should be targetted, potent, of adequate duration, and possibly integrated within specialist clinic services.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.75376 |
| Date | January 1986 |
| Creators | Nolan, Terence. |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 000419859, proquestno: AAINL38374, Theses scanned by UMI/ProQuest. |
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